Christian K Spies1, Anja Niehoff2,3, Frank Unglaub4,5, Lars P Müller6, Martin F Langer7, Wolfram F Neiss8, Johannes Oppermann6. 1. Department of Hand Surgery, Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Germany. christianspies27@gmail.com. 2. Cologne Center for Musculoskeletal Biomechanics (CCMB) Medical Faculty, University of Cologne, Joseph-Stelzmann-Str. 9, 50931, Köln, Germany. 3. Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Köln, Germany. 4. Department of Hand Surgery, Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Germany. 5. Medical Faculty Mannheim of the Ruprecht-Karls University Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. 6. Department of Orthopaedics and Traumatology, University Hospital Cologne, Kerpener Str. 62, 50937, Köln, Germany. 7. Department of Orthopaedics and Traumatology, University Hospital Münster, Waldeyerstr. 1, 48129, Münster, Germany. 8. Department of Anatomy I, Medical Faculty, University of Cologne, Kerpener Str. 62, 50937, Köln, Germany.
Abstract
PURPOSE: We hypothesized that the re-fixation of the deep and superficial fibres of the distal radioulnar ligaments provide improved stability compared to reconstruction of the deep fibres alone. METHODS: Fourteen fresh-frozen cadaver upper extremities were used for biomechanical testing. Transosseous re-fixation of the deep fibres of the distal radioulnar ligaments alone (single mattress suture group; n = 7) was compared to the transosseous re-attachment of the deep and superficial fibres (double mattress suture group; n = 7). Cyclic load application provoked palmar translation of the radius with respect to the rigidly affixed ulna. Creep, stiffness, and hysteresis were obtained from the load-deformation curves, respectively. Testing was done in neutral forearm rotation, 60° pronation, and 60° supination. RESULTS: The re-fixation techniques did not differ significantly regarding the viscoelastic parameters creep, hysteresis, and stiffness. Several significant differences of one cycle to the consecutive one within each re-fixation group could be detected especially for creep and hysteresis. No significant differences between the different forearm positions could be detected for each viscoelastic parameter. CONCLUSIONS: The re-fixation techniques did not differ significantly regarding creep, hysteresis, and stiffness. This means that the additional re-attachment of the superficial fibres may not provide greater stability to the DRUJ. Bearing in mind that the study was a cadaver examination with a limited number of specimens we may suppose that the re-attachment of the superficial fibres seem to be unnecessary. A gradual decline of creep and hysteresis from first to last loading-unloading cycle is to be expected and typical of ligaments which are viscoelastic.
PURPOSE: We hypothesized that the re-fixation of the deep and superficial fibres of the distal radioulnar ligaments provide improved stability compared to reconstruction of the deep fibres alone. METHODS: Fourteen fresh-frozen cadaver upper extremities were used for biomechanical testing. Transosseous re-fixation of the deep fibres of the distal radioulnar ligaments alone (single mattress suture group; n = 7) was compared to the transosseous re-attachment of the deep and superficial fibres (double mattress suture group; n = 7). Cyclic load application provoked palmar translation of the radius with respect to the rigidly affixed ulna. Creep, stiffness, and hysteresis were obtained from the load-deformation curves, respectively. Testing was done in neutral forearm rotation, 60° pronation, and 60° supination. RESULTS: The re-fixation techniques did not differ significantly regarding the viscoelastic parameters creep, hysteresis, and stiffness. Several significant differences of one cycle to the consecutive one within each re-fixation group could be detected especially for creep and hysteresis. No significant differences between the different forearm positions could be detected for each viscoelastic parameter. CONCLUSIONS: The re-fixation techniques did not differ significantly regarding creep, hysteresis, and stiffness. This means that the additional re-attachment of the superficial fibres may not provide greater stability to the DRUJ. Bearing in mind that the study was a cadaver examination with a limited number of specimens we may suppose that the re-attachment of the superficial fibres seem to be unnecessary. A gradual decline of creep and hysteresis from first to last loading-unloading cycle is to be expected and typical of ligaments which are viscoelastic.
Authors: Jan-Ragnar Haugstvedt; Richard A Berger; Lawrence J Berglund; Patricia G Neale; Michelle B Sabick Journal: J Hand Surg Am Date: 2002-01 Impact factor: 2.230